How melanoma is diagnosed
If you have a suspected melanoma, you should be seen within a couple of weeks by a dermatologist.
Usually you’ll begin by seeing your GP, who will examine you. If your GP thinks you may have a melanoma, they should refer you urgently to a doctor with specialist training in diagnosing skin conditions, including cancer (a dermatologist).
It’s important to find and treat melanoma as early as possible. If a melanoma is not removed, the cells can grow down deeper into the layers of the skin. These layers contain tiny blood vessels and lymphatic tubes (ducts), which form part of our immune system. If the melanoma cells go into the blood vessels or lymphatic tubes, they can travel to other parts of the body. Early-stage melanomas are unlikely to spread into the blood vessels or lymphatic tubes.
Your appointment will probably be at a skin clinic or at a pigmented lesion clinic (a special clinic for diagnosing melanomas early). Some people may see a plastic surgeon rather than a dermatologist. They are also experienced in treating melanoma.
The specialist will examine your mole and ask you questions about how long you’ve had it and any changes you’ve noticed. They usually also examine the rest of your skin to see if you have any other unusual moles. Some specialists may look at your moles with a small, hand-held instrument called a dermatoscope. This gives a bigger and clearer picture of the mole, but it’s not always necessary to have this test.
Your specialist will be able to tell a lot by knowing how your mole has behaved and looking at it. If they think you may have a melanoma, your specialist will advise you to have the whole mole removed (excision biopsy). You may also see to a specialist skin cancer nurse, who will give you information and support.
Removing the mole (excision biopsy)
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Once you’re lying down comfortably, your doctor will inject a local anaesthetic around the area of the mole. After this, they’ll cut out the whole mole and 2mm of normal skin around it. You won’t feel this because the local anaesthetic numbs the area. Your doctor will then close the wound using stitches. These will be removed after 5-14 days, depending on where the mole was. Some people may have stitches that dissolve and don’t need to be removed.
The mole is examined under the microscope by a pathologist (a doctor who advises on the type and extent of the melanoma) to see if any melanoma cells are present. It’s likely that you’ll get the results within a few weeks when you return to the clinic. If it’s confirmed that you had a melanoma, your specialist will talk to you about having further surgery, known as a wide local excision.
A wide local excision is done to make sure that all the melanoma cells in the area have been removed and to reduce the chance of the melanoma coming back.
You may have further tests to check whether cancer cells have spead to lymph nodes nearby or to other parts of the body.